title: Solid-organ transplantation in childhood: transitioning to adult health care.
abstract: Pediatric solid-organ transplantation is an increasingly successful treatment for solid-organ failure. With dramatic improvements in patient survival rates over the last several decades, there has been a corresponding emergence of complications attributable to pretransplant factors, transplantation itself, and the management of transplantation with effective immunosuppression. The predominant solid-organ transplantation sequelae are medical and psychosocial. These sequelae have a substantial effect on transition to adult care; as such, hurdles to successful transition of care arise from the patients, their families, and pediatric and adult health care providers. Crucial to successful transitioning is the ongoing development of a sense of autonomy and responsibility for one's own care. In this article we address the barriers to transitioning that occur with long-term survival in pediatric solid-organ transplantation. Although a particular transitioning model is not promoted, practical tools and strategies that contribute to successful transitioning of pediatric patients who have received a transplant are suggested.
authors.affiliation: Division of Nephrology, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. larosac@email.chop.edu
authors.forename: Christopher
authors.initials: C
authors.lastname: LaRosa
authors.forename: Caryle
authors.initials: C
authors.lastname: Glah
authors.forename: H Jorge
authors.initials: HJ
authors.lastname: Baluarte
authors.forename: Kevin E C
authors.initials: KE
authors.lastname: Meyers
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003299:Cooperative Behavior; D004185:Disability Evaluation; D006084:Graft Rejection / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D057187:Independent Living / Q000523:psychology; D019458:Insurance Coverage; D033183:Interdisciplinary Communication; D055118:Medication Adherence / Q000523:psychology; D016377:Organ Transplantation / Q000523:psychology; D010348:Patient Care Team; D026684:Personal Autonomy; D011183:Postoperative Complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology; D012017:Referral and Consultation; D012917:Social Adjustment; D017741:Survivors; D014164:Transfer Agreement; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents